Provider Demographics
NPI:1215938444
Name:BARTOW REHABILITATION CENTER, LLC
Entity type:Organization
Organization Name:BARTOW REHABILITATION CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-346-6454
Mailing Address - Street 1:1665 PALM BEACH LAKES BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2108
Mailing Address - Country:US
Mailing Address - Phone:561-801-7600
Mailing Address - Fax:
Practice Address - Street 1:2055 E GEORGIA ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-6710
Practice Address - Country:US
Practice Address - Phone:863-533-0578
Practice Address - Fax:863-533-0736
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTHSTONE SENIOR COMMUNITIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1032096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014064800Medicaid
FL105286Medicare Oscar/Certification